LEOMINSTER — HealthAlliance Hospital is proposing to cut 20 full-time equivalent nursing positions at its Leominster campus in addition to cuts to support staff at both the Leominster and Fitchburg campuses and conduct a massive reorganization, a spokesman for the Massachusetts Nurses Association said.

The announcement of more cuts by President and Chief Executive Officer Deborah Weymouth comes just two months after HealthAlliance Hospital cut seven full-time nursing positions from the Fitchburg campus.

In a letter Wednesday from Ms. Weymouth sent to HealthAlliance employees, Ms. Weymouth said the cuts will take place from now until the end of the hospital's current fiscal year that ends Sept. 30.

The proposed cuts may jeopardize the quality of care for patients by increasing nurse-to-patient ratios to a dangerous level, said David J. Schildmeier, spokesman for the Massachusetts' Nurses Association.

"They have 'bumping rights' in their contract based on their seniority," Mr. Schildmeier said. "If they cut 20 nurses, nurses can bump other nurses with lesser seniority in other units throughout the hospital. It could impact 50 or 60 people by the time it gets done. It wreaks havoc throughout the entire facility and disrupts the quality of care on those units and quality of life of the nurses affected."

Mr. Schildmeier said the union is prepared to battle hospital administrators and will wage a campaign to educate the public on how "dangerous the hospital's decisions are."

Kelli Rooney, a spokeswoman for HealthAlliance who responded to the union's allegations, said the hospital's number one goal is to put patients first and to deliver high-quality care in an efficient and cost-effective way.

"We assure you that we are taking all reasonable measures to ensure there will be no disruption to the quality of patient care in all areas of our organization," Ms. Rooney said.

Ms. Rooney also denied the union's allegations that HealthAlliance is reneging on its promise to the Department of Public Health and the community to accommodate mental health patients at the Leominster campus when it closed the 15-bed psychiatric unit at the Burbank campus in Fitchburg in 2011.

"We have restructured our mental health care offering to best meet the changing mental health care needs in the community with a new model of care that is aimed at partnering our health care expertise along with other inpatient, outpatient and health programs within the community," Ms. Rooney said.

Theresa M. Love, a nurse in the Leominster campus' pediatric and surgical unit who was hired in 2000, said all staff at the hospital are really concerned about patient safety, quality of care and where the hospital will be in three to five years.

Administrators provided staff with a matrix that shows reductions or changes to staffing patterns in each unit, she said. Some floors will have higher nurse-to-patient ratios on certain shifts or on a regular basis, she said. That may mean a 1-to-6 ratio or higher that will reduce quality of care, she said.

"If you have six patients, you still only have so much time in a period to take care of those patients," Ms. Love said. "Nobody wants to be patient number 6. You're not less sick at 10:30 at night than you are at 11:05 at night. You're not less sick if you're on the fourth floor than you are if you're on the third floor."

Proposed changes in the emergency room would mean higher wait times for patients and more responsibilities for mental health counselors, she said.

The hospital hires per diem nurses an average of 427 hours a week now, she said, and nurses on staff cover 13,000 hours of extra shifts each year.

"I don't understand how they can make these cuts and still staff the hospital appropriately," she said.

Also of concern is that the union has asked for the consultant's report the hospital used to base the proposed changes on, but they have not provided it, she said.

"They are stalling and we're wondering what is in that report," Ms. Love added.

The union is meeting with hospital administrators on Monday to negotiate, Mr. Schildmeier said, and the DPH must also approve the cuts.

In Ms. Weymouth's letter, she said cuts are necessary because hospital volume is decreasing both nationally and throughout Central Massachusetts due to changes in insurance plans and technology.

However, the union alleges part of the reason patient volume is down is because the hospital is not replacing physicians who have retired or have left to work in other facilities. Subsequently, there are fewer physicians admitting patients, Mr. Schildmeier said. The hospital is also proposing shutting down one of the operating rooms because there are not enough surgeries being scheduled, he said.

Mr. Schildmeier said if the proposed cuts are made, patients from the Leominster and Fitchburg area may have to travel to Worcester or other communities for care.

"We are flabbergasted by the lack of preparation," he said. "We've asked them if they have a plan to replace the physicians who are leaving to keep up volume and keep the hospital viable, but they don't have one. It will lower the standard of care for patients who are losing access to physicians. Patients will have to travel to Worcester and other areas who should and could get care in Leominster."

Contact Paula Owen at powen@telegram.com.

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